The purpose of this study was to investigate variables of significantly difference as the structure of the spine, pelvic deviation and foot pressure between undergraduates and golf player subjects. The subjects of study were composed of 20 male golf players and 20 male undergraduates. Both groups were right handed persons. The measurement tools of this study were Formetric 4D(Diers, Germany) which is a three dimensional measure. The result are the follows: there were a significant difference between golf players and general students of trunk imbalance, pelvic tilt, pelvic torsion, pelvic rotation, surface rotation, lumbar lordotic curve, foot pressure(fore & behind foot), weight distribution(right & left foot). In conclusion, golf players might cause transform of spine and foot pressure due to golf exercise for several years. Such as imbalance affect to induce functional impairment and pain of musculoskeletal system, and appropriate evaluation and treatment were necessary for golf players.
Objective : Spondylothesis is a disease which sagittal facet of vertebral body's invariable alignment is being broken and vertebral body being pushed forward. Main pattern of spondylothesis is isthmic spondylothesis by isthmus defect or fracture, degenerative spondylothesis occurred by desiccated change of intervertebral disc or vertebral condyle joint's ligament. The purpose of this study is to assess the difference of the Pelvic angles, Lumbosacral angles, Pelvic tilt, and Lumbar lordotic angles of the spondylothesis patients. Methods : We analyzed the lateral view of lumbar spine of 49 isthmic spondylothesis patients, 45 degenerative spondylothesis patients and 26 patients who haven't been diagnosed as vertebra disease. We investigated each patient's pelvic angle, lumbosacral angle, pelvic tilt and lumbar lordotic angle. Results and Conclusion : 1. Pelvic incidence, in cases of degenerate spondylothesis patients, is higher than spondylothesis patients but shows less significance. On the contrary significance is higher than the group haven't been diagnosed as vertebra disease. 2. Lumbosacral incidence, in cases of isthmic spondylothesis patients, shows higher significance than degenerative spondylothesis patients and the group haven't been diagnosed as vertebra disease. 3 Pelvic tilt, in cases of degenerative spondylothesis patients, shows higher significance than isthmic spondylothesis patients and the group haven't been diagnosed as vertebra disease. 4. Lumbar lordotic angle, in cases of isthmic spondylothesis patients, shows higher significance than degenerative spondylothesis patients and the group haven't been diagnosed as vertebra disease. 5. Degenerative spondylothesis patient shows specific impression, a forwardly moved high femoral axial and as a result of large lumbrosacral angle and lumbar lordotic angle shows specific impression, an increased weight pressure on sacrum.
Purpose: The purpose of this study is to compare kinematics on lower limbs between stair walking with high heel and barefoot in healthy adult women. Methods: 18 healthy adult women were recruited in this study. The subjects performed stair ascent and descent with high heels and barefoot. The experiment was conducted in random order and repeated three times for each stair walking with high heels and barefoot. The movements of lower limb joints were measured and analyzed using a three-dimensional analysis system. Results: The ankle, knee, and hip flexion angles on the sagittal plane exhibited statistically significant differences between stair ascent and descent with high heels and barefoot. The pelvic forward tilt angles showed statistically significant differences only during stair ascent. The ankle inversion, hip abduction and pelvic lateral tilt angles on the frontal plane showed statistically significant differences between stair walking with high heels and barefoot. On the transverse plane, the hip rotation angles showed statistically significant differences between the high-heeled and barefoot gait during stair ascent and descent. However, the pelvic rotation angles showed no statistically significant differences. Conclusion: Therefore, wearing high-heeled shoes during stair walking in daily life is considered to influence lower limb kinematics due to the high heel, and thus poses the risks of pain, and low stability and joint damage caused by changes in the movement of lower limb joints.
Purpose: To determine the normative data for the correlation of spinal, pelvic parameters with foot pressure in the young subjects. Methods: The subjects of this study were 39 patients in healthy adults. The Formetric-III was used to measure of spinal alignment. The pedoscan was used to measure of foot pressure. The correlation of trunk imbalance, trunk inclination, lateral deviation with foot pressure. The foot pressure measurement was consisted of maximal/mean pressure, weight contribution. Result: There was a negative correlation of trunk inclination with Max_R. There was a negative correlation of trunk inclination with Max_R. There was a positive correlation of trunk imbalance with Max_L. There was a positive correlation of lumbar lordosis with Mean_R_front, Lt. posterior weight distribution. There was a negative correlation of lumbar lordosis with Lt., Rt. in distribution There was a negative correlation of pelvic tilt with Mean_R_front, Lt. posterior weight distribution. There was a positive correlation of pelvic tilting with Rt. weight distribution, Lt. posterior weight distribution. There was a negative correlation of pelvic torsion with Lt. weight distribution, Rt. posterior weight distribution. There was a negative correlation of pelvic rotation with Lt. weight distribution, Lt. posterior weight distribution. Conclusion: The data obtained from the study may be used for future studies related to correlation of the spinal, pelvic deviation with foot pressure.
This study investigated therapeutic effects of pelvic tilt exercise (PTE) on weight bearing and body sway during sit-to-stand (STS) on 18 hemiplegic patients who had visited the Hanyang University Seoul Hospital and Injae University Sanggyebek Hospital physiotherapy rooms. The study compared the patients with 18 normal adults. The subjects were sampled out from those who could get up independently, maintain a standing posture more than 10 seconds, understand the movements of this study and have no difficulty in performing the tasks. By executing STS in a natural way with habitual movements before and after PTE, the weight bearing was measured by using Mediance II. In order to compare the difference of weight distribution, weight bearing and body sway on affected and nonaffected sides during STS before and after PTE, the Wilcoxon Signed Ranks Test was used. The statistical significance level was based on p<.05. The results revealed that the difference of weight distribution in the hemiplegic group was significantly decreased (p<.05), whereas there was no significant difference in the healthy group (p>.05). Weight bearing loaded on the affected side was $42.53{\pm}7.65%$ and $44.20{\pm}6.32%$, respectively, in the hemiplegic group during STS before and after PTE. Weight bearing during STS after PTE is increased significantly, as compared with weight bearing before PTE (p<.05). Body sway in the hemiplegic group was significantly decreased (p<.05). As mentioned, PTE proved to be effective for improvement in weight bearing on the affected side during STS of hemiplegic patients.
Purpose : This study aimed to examine the relationships among five clinical measures for functional alignment of the lower extremity. Methods : Thirty healthy subjects (15 males and 15 females) were recruited for the study. The five clinical measures of functional alignment of the lower extremity included navicular drop, quadriceps angle, internal rotation of hip, and anterior and lateral pelvic tilt angles. The level of navicular drop was calculated by the difference between the height of the navicular bone in the sitting (non-weight bearing) and standing (weight bearing) positions. The quadriceps angle and internal rotation of hip were measured using a standard goniometer with photographic markers while the subjects were lying in a prone position on a table with their knee at $90^{\circ}$ flexion. Anterior and lateral pelvic tilt angles were determined using a inclinometer. Results : Correlation and a simple linear regression analysis were used to assess relationships between the clinical measures. There were significant correlations between navicular drop and quadriceps angle (p<.05), between navicular drop and internal rotation of hip (p<.05), and between quadriceps angle and internal rotation of hip (p<.01). In simple linear regression analysis, the navicular drop appeared to be a factor affecting the quadriceps angle and internal rotation of hip (p<.05). The findings suggest that navicular drop has a great impact on lower extremity alignment. Conclusion : This study might help us to examine lower extremity function and clarify its role as a potential injury risk factor.
Seo, Jun-Yeong;Ha, Kee-Yong;Kim, Young-Hoon;Kim, Seong-Chan;Yoon, Eun-Ji;Park, Hyung-Youl
Journal of Korean Medical Science
/
제33권48호
/
pp.316.1-316.10
/
2018
Background: Water pressure and muscle contraction may influence bone mineral density (BMD) in a positive way. However, divers experience weightlessness, which has a negative effect on BMD. The present study investigated BMD difference in normal controls and woman free-divers with vertebral fracture and with no fracture. Methods: Between January 2010 and December 2014, traditional woman divers (known as Haenyeo in Korean), and non-diving women were investigated. The study population was divided into osteoporotic vertebral fracture and non-fracture groups. The BMD of the lumbar spine and femoral neck was measured. The radiological parameters for global spinal sagittal balance were measured. Results: Thirty free-diving women and thirty-three non-diving women were enrolled in this study. The mean age of the divers was $72.1{\pm}4.7$ years and that of the controls was $72.7{\pm}4.0$ years (P = 0.61). There was no statistical difference in BMD between the divers and controls. In divers, cervical lordosis and pelvic tilt were significantly increased in the fracture subgroup compared to the non-fracture subgroup (P = 0.028 and P = 0.008, respectively). Sagittal vertical axis was statistically significantly correlated with cervical lordosis (Spearman's rho R = 0.41, P = 0.03), and pelvic tilt (Spearman's rho R = 0.46, P = 0.01) in divers. Conclusion: BMD did not differ significantly between divers and controls during their postmenopausal period. When osteoporotic spinal fractures develop, compensation mechanisms, such as increased cervical lordosis and pelvic tilt, was more evident in traditional woman divers. This may be due to the superior back muscle strength and spinal mobility of this group of women.
Background: In patients with lumbar spinal stenosis (LSS), lumbar flexion exercise (LFE) is considered a standard therapeutic exercise that widens the space between the spinal canal and intervertebral foramen. However, some researchers have reported that lumbar extension exercise (LEE) may improve lumbar pain and functional ability in patients with LSS. Although exercise intervention methods for patients with LSS have been widely applied in clinical settings, few studies have conducted comparative analysis of these exercise methods. Objects: This study aimed to compare the effects of LFE, LEE, and lumbar flexion combined with lumbar flexion-extension exercise (LFEE) on pain, range of motion (ROM), pelvic tilt angle, and functional gait ability in patients with LSS. Methods: A total of 30 patients with LSS, LFE (n1=10), LEE (n2=10), and LFEE (n3=10) were assigned to each of the three exercise groups. The numerical pain rating scale (NPRS), modified-modified schober test (MMST)-flexion, MMST-extension, pelvic tilt inclinometer, and 6-minute walking test (6MWT) were measured. Results: After the intervention, statistically significant differences were observed in the NPRS (p=.043), MMST-flexion (p<.001), MMST-extension (p<.001), and 6MWT (p=.005) between groups. According to the post hoc test, the NPRS was statistically significant difference between the LFEE and LEE groups (p=.034). The MMST-flexion was statistically significantly different between the LFE and LEE (p=.000), LFE and LFEE (p=.001), and LEE and LFEE (p=.001) groups. The MMST-extension was statistically significantly different between the LFE and LEE (p<.001), LFE and LFEE (p=.002), and LEE and LFEE (p=.008) groups. The 6MWT was statistically significantly different between the LFE and LFEE (p=.042) and the LEE and LFEE (p=.004) groups. Conclusion: This study suggested that LFEE was the most effective exercise for pain and functional gait ability in patients with LSS, LFE was the most effective exercise for lumbar flexion ROM, and LEE was the most effective exercise for lumbar extension ROM.
PURPOSE: This study examined the effects of wall-squat with short-foot exercise on pain, dysfunction, and pelvic alignment in chronic low back pain patients. METHODS: Thirty outpatients diagnosed with chronic low back pain and pronated foot were enrolled in this study. The patients were divided randomly into a wall-squat with short-foot exercise group (WS; n = 15) and a normal wall-squat exercise group (NW; n = 15). These groups performed their respective exercises 15 times, for three sets, three times a week over six weeks. The visual analogue scale (VAS) was used to measure the subjects' pain, and the Roland-Morris disability questionnaire (RMDQ) was used to measure the subjects' dysfunction. A navicular drop test (NDT) was used to measure the subjects' arch height. To assess the patients' pelvic alignment, their lordosis, sacral tilt, lumbar width, sacral width, ilium length, and ilium width were measured by X-ray imaging. RESULTS: Both the WS and NW groups exhibited significant decreases in their VAS and RMDQ scores after exercise (p < .05). The WS group exhibited significant increases in their arch height (p < .05). Significant differences in the VAS, sacral tilt, sacral width, and ilium length were observed between the WS and NW groups (p < .05). CONCLUSION: These results suggest that wall-squat exercise is effective in decreasing the level of pain and dysfunction in chronic low back pain patients. In addition, the wall-squat with short-foot exercise is considered more effective in improving the pelvic alignment than without short-foot exercise. This can be an effective method for the non-pharmacological and non-surgical treatment of chronic low back pain
Study Design: Biomechanical study. Purpose: To investigate the relative stiffness of a new posterior pelvic fixation for unstable vertical fractures of the sacrum. Overview of Literature: The reported operative fixation techniques for vertical sacral fractures include iliosacral screw, sacral bar fixations, transiliac plating, and local plate osteosynthesis. Clinical as well as biomechanical studies have demonstrated that these conventional techniques are insufficient to stabilize the vertically unstable sacral fractures. Methods: To simulate a vertically unstable fractured sacrum, 12 synthetic pelvic models were prepared. In each model, a 5-mm gap was created through the left transforaminal zone (Denis zone II). The pubic symphysis was completely separated and then stabilized using a 3.5-mm reconstruction plate. Four each of the unstable pelvic models were then fixed with two iliosacral screws, a tension band plate, or a transiliac fixation plus one iliosacral screw. The left hemipelvis of these specimens was docked to a rigid base plate and loaded on an S1 endplate by using the Zwick Roell z010 material testing machine. Then, the vertical displacement and coronal tilt of the right hemipelves and the applied force were measured. Results: The transiliac fixation plus one iliosacral screw constructions could withstand a force at 5 mm of vertical displacement greater than the two iliosacral screw constructions (p=0.012) and the tension band plate constructions (p=0.003). The tension band plate constructions could withstand a force at $5^{\circ}$ of coronal tilt less than the two iliosacral screw constructions (p=0.027) and the transiliac fixation plus one iliosacral screw constructions (p=0.049). Conclusions: This study proposes the use of transiliac fixation in addition to an iliosacral screw to stabilize vertically unstable sacral fractures. Our biomechanical data demonstrated the superiority of adding transiliac fixation to withstand vertical displacement forces.
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